How to Treat Blisters

Do you remember the old fairytale of the Princess and the Pea? Even when the Princess was lying on top of 99 mattresses, she could still feel the tiny little pea hidden underneath at the very bottom. In the same way, it’s incredible how something that can be so tiny (yes, pea sized) can cause so much grief and trouble when out hiking in the bush. How is it that something so small can reduce grown adults to jittery messes, ruining an otherwise wonderful outdoors adventure? Is it any wonder that it’s vital for every hiker, trail-runner, bushwalker and trekker to learn how to treat blisters?

The trick is to not let it get this far!

Preventing blisters is the key

Like so many things to do with spending time outdoors, a little bit of planning and preparation certainly makes all the difference. This includes:

Breaking in your shoes – This may sound like the most obvious preventative, but so many people seem to ignore this step, even when undertaking multi-day trekking adventures or ultra marathon events, even when they’ve known about them for months. Simply wearing your new shoes around the house or to the office for a couple of days beforehand isn’t going to cut the mustard. You need to put your feet and shoes through their paces by doing the planned activity in them, in similar terrain, for an extended period of time. In our busy lives this isn’t always possible, but do the best you can. If you’re going trekking, wear your new shoes/boots whilst doing training walks, with a pack of the same weight that you’ll be carrying, on rough terrain. Build up your ‘foot fitness’ the same as your body. Start with a couple of hours at first, then half a day and eventually a full day.

Toughening up your skin – There’s a few different ways of doing this, but the best one I’ve found is to spend as much time as possible walking around the house in bare feet. You could also try wearing your shoes without socks for shorter walks (watch out for hot spots!) and I’ve had some success with the methylated spirits technique.

Good quality socks – Sometimes it feels as though the humble sock goes through some sort of scientific breakthrough every week with new materials and designs. As much as some of this is marketing hype, the outcomes from wearing good quality socks, designed for your sport, can’t be denied. I’m a fan of merino wool for their wicking qualities and ability to breathe… not to mention the non-stinky factor.

Learning to tie your laces – isn’t just something you do in kindergarten. By being smart with the way you lace your shoes and tie them, you can shift the pressure points in your shoe for maximum comfort and stability. I’ll be doing a future post on this soon!

Pre-emptive strike – If you are susceptible to blisters or hotspots and know where they occur, I recommend arming your feet in advance. You can use tape eg. Fixomul or Wonderwool.

During an activity – What to do with blisters?

If you’re out on a hike and start to feel a little niggle in your shoes (no matter how tiny), I have one thing to say to you. Stop. Stop now. Stop quickly. Don’t hesitate. Don’t think it will get better – it won’t. And whatever you do, don’t think you’ll just keep powering on because you don’t want to hold up the rest of your party. Trust me, your whole group will be much happier if you address the hot spot now, whilst it is manageable and treatable, rather than waiting until the skin flap has torn and you’ve got a bleeding, weeping, oozy mess in your shoes that you can’t walk on.

There’s 3 (or 4!) different levels of blisters:

Hot Spot

Closed Blister

Open/Torn Blister

Disgusting, debilitating mess

How can something so small ruin our day?

How to Treat a Blister Hot Spot

A hot spot is the first stage of a blister, before the liquid has formed and a blister is apparent. As the name suggests, it will just be a point of rubbing, pain or discomfort in your shoes. That is the moment you need to stop and treat it before it develops into a blister. Here’s some tips on how to treat a blister hotspot.

Start by removing or repairing the cause of the hotspot. Take a look at your shoe, socks, lacing, toes and toe nails. Is there something there causing rubbing that you can fix? Shake out the shoes for any hidden grit, sand, dirt and debris, inspect the inside of your shoe and sock for any offending items.

Protect the hotspot from developing into a blister by applying padding and protection for it. My weapon of choice is humble Fixomul, which is a slightly stretchy, mesh, breathable tape. If it’s a very minor niggle, I’ll just apply one layer, however the great thing about Fixomul is that you can add layer upon layer. Make sure that there’s no folds in the tape and keep it smooth in application, otherwise you could develop another hotspot.

Another approach is to use a product such as WonderWool. This all natural, straight off a sheep’s back fluffy goodness, is like taking the best bits of your ugg boots and inserting pieces of it inside your socks. It is designed to not only absorb moisture, but to also provide padding and separation between rubbing points. It’s particularly good between toes.

So, if you’ve (sadly), moved past the limits of a hotspot and developed a blister, you’ll find yourself faced with a decision. To pop or not to pop? In the end it has to be your choice and depends on many factors. Do you need to keep moving in these shoes? How far/long? Are you in a climate or conditions where infection is more prevalent? For myself, I generally choose to pop and here’s my process:

How to treat a blister

I feel that popping or lancing a blister to drain it is the best approach. The reason is that you’re able to control the manner in which it pops, release the liquid, clean and then apply an appropriate dressing to aid healing and hopefully avoid infection and assist in pain management. If you leave the blister closed, just cover it and keep walking in the same shoes, you’re at risk of the skin flap tearing in an uncontrolled way and then having more issues to deal with.

Clean the blister and surrounding area with antiseptic (eg. Betadine) solution.

Using a sterilised needle or lance, pierce the blister skin and gently drain the fluid away. Depending on the size, I will pierce it in 2 or 3 places to evenly drain the fluid.

If the blister is particularly bad or painful it’s important to apply padding: cut a ring shaped donut from something like a foam mat, to protect the blister from having something applied directly over the top.

Protect a blister by making a foam ring and fixing it in place with tape

At the end of each day

Give your feet a chance to dry out and escape from their sweaty homes, especially if you’ve done any creek crossings and have wet shoes and socks. Taking a pair of Crocs and clean, dry socks for camp is a simple, lightweight way of doing this, whilst protecting your feet from any injury around camp.

Use fresh socks with no grit or sand in them and watch out for older socks becoming ‘crusty’.

After your activity and the blister has healed, start the cycle again of trying to toughen up your feet and continuing to break your shoes in.

Giveaway!

Thanks to the lovely folk at WonderWool, I have 5 packets of their woolly goodness to giveaway to Lotsafreshair readers. [Competition is now closed. Thanks for your interest and congrats to the winners. Congrats to: Sonya, Adam, Kelly-Anne, Simon and Meg!]

Comments

Sound advice folks, take note! Having completed the month long slog of the Camino de Santiago across the top of Spain last year, I saw many who didn’t make it because of blisters. If I can add one further suggestion: use good-quality silk socks as liners to your thick wool. They are so much easier to wash and dry overnight and ensure an excellent fit. Never had a single blister in 550 km of daily walking.

Have to agree with Lee about the use of silk (or other) sock liners inside the heavier socks. Seems to prevent the friction by allowing a sliding surface within the socks. Mixed view on draining blisters – agree it reduces the size and discomfort and the risk of tearing, but it does allow a point of entry for bugs no matter how much Betadine, etc you use. I’ve found ‘it depends’; some blisters can be left intact and taped and will disappear on their own especially if the friction source is removed. Others, particularly if they are going to tear anyway, are best drained, etc. Finally, its just so important to get boots that fit! Many boots are made with very narrow lasts and are certain to give trouble. I typically try quite a few boots, even the same brand and size before I get ones that are the right size.

I blistered badly on the balls of my feet and in between my toes training for the Oxfam Trailwalker, 100km I now strap the balls of my feet and wear Injinji toe socks as “inner” socks. Works a treat for me.

Great article! Blisters are the worst. My two hints, wear light weight trail runners instead of big heavy boots. Toughen those feet. 6 weeks before I run a trail ultra I spend several hour a day standing barefoot in a tray of pebbles. My first trail ultra was torture due to ill prepared feet.

Some observations from a few long events – 1. Don’t wait for blisters to apply tape. If you’re on a big walk or run – tape prone areas before the event – heels and toes especially. That thin white sports tape. On an ultra I do pretty much my whole feet in tape. The sock/shoe rubs the tape not your skin. – use generous amounts of tape – you don’t want a lose end rubbing off making a hot spot – BUT do not wrap the tape around your feet like a mummy in one strip – do it in strips with gaps! As the event progresses your feet will expand – the tape won’t – choking off your circulation. And cut your toes nails as short as you can. 2. Spray your feet with antiperspirant. Sounds weird but friction and moisture = blisters – cut out the moisture – work esp well in shorter events. 3. Change your socks at checkpoints – see above esp if you’ve done water crossing – you can even change shoes if you have several well fitting pairs- but I tend to like a pair and stick with them for the race if they are working ok. Shoes tend to dry out esp if you change wet socks. 4. Proper fitting shoes – as a size UK 7.5 but 3xE wide – I’ve got a short and very wide foot/flipper – very difficult to fit the right shoe – and I’ve found that as I’m used to wearing uncomfortable shoes – I accept it in daily life – but for longer events go to a good sports shoe fitter (and once you know your proper size and good brands for your foot type – you can buy cheaper online.. sorry Atheletes Foot…) some brands don’t got to 3-4E width and some brands seem regularly wider than others – and you really do still have to wear them in.. 5. If it all goes bad – you can cut out sections of shoes – I’ve seen competitors finish with heals or toes cut out of their shoes. I have a 20 year old pair of runners that I use as backup in my checkpoint box – they are stretched and worn and completely aligned to my feet and very loose – but have zero sole compression left – but will get me the last 10km. Note – when fitting shoes for longer events – get the right fitting shoe – then go 1/2 size up. Under strain your feet will swell. 6. Toughen up your feet. Wear in those shoes for at least several weeks and in the same conditions with the same socks, running rough trails, get your feet wet etc. and rub them with metho twice a day for a few weeks. I don’t know why but some old school nurses told me this is what they did for bedsores in the olde times and it supposed to toughen up the skins outer layer. 7. As the article mentions – deal with ‘hot spots’ straight away – that tiny niggling rubbing on your toe can turn into a race finishing agony 25 km later. It might just be a wrinkle in your sock, a change of socks or some tape – but a 5 minute action early might see you finish instead of drop out. 8. And lastly – toughen up.. a marathon or a100km race is going to hurt somewhere.. focus on the finish not on the pain – blisters and muscle twinges will be gone in a few days – the disappointment of not finishing won’t. I’ve found that redirecting your attention works wonders – legs aching – don’t focus on your legs – wow my arms feel really good – look at that great sunset etc if you focus on the pain it will intensify. Remember pain receptors are in your body – you can’t stop those – but acknowledging those pain receptors is in your brain – you can distract it redirect that – to a point though you don’t want to really injure yourself. Sorry that went for a lot longer than it was supposed to.. but as someone who’s prone to blistering I’ve had a lot of experience…

Excellent article – thanks. I hadn’t heard of the metho treatment before, so will certainly try that next time. Have very recently completed the 8 day Great Ocean Walk and got a huge heel blister in the early stages, despite doing many of the preventative techniques raised in the article, like walking barefoot around the house, walking/wearing in my boots (although that was only with a day pack, rather than a full pack – which I think was the problem & cause of the blister). I also wore very comfortable socks that had never caused problems before even on 3 day walks. I also endorse Rob v’s advice about diverting your thinking away from the pain. I walked for 5 days with the burst heel blister and just concentrated on getting the bandaging right in the morning to minimise the pain and then focused on the scenery, my photography, the track, etc and ignored the pain. It works very well. I have succeeded with that technique previously when blisters or bites have occurred. If you want to do the walk – just get on and do it, is my philosophy. GOW Day8 March18-3115.jpg GOW Day8J March18-1050620.jpg

Thanks for a great article! I consider myself a blister veteran… I have extremely broad, different-sized feet with a bunion on one side. At one point I just accepted that blisters were par for the course/ the pay-off for the joy of being out hiking. There is a happy ending though if you can hold out to the end of the post!

Things I found worked (apologies for ideas already mentioned): 1. Preventative measures: knowing your usual hotspots, and taping them pre-emptively. It seems like you essentially need to prevent *moist friction* to prevent a blister. If you’re doing a hot, humid hike, then some tincture of benzoin helps the tape to stick. Same principle that explains why merino wool socks are so freaking awesome, they absorb moisture with minimal friction. 2. Blister plasters. Available from Scholl or Elastoplast. They have an absorbent pad in the middle that absorbs the blister juice. Just apply to closed blister and leave it on til the plaster actually falls off. I used to pop the blister first but found the blister plaster works much better (and with less pain) on a closed blister. Can be a bit spensy but they work!!

Then one day I bought myself a pair of Salomons in the vague hope they’d be an improvement on the stupidly expensive fancy leather ones I’d had before… and they have changed hiking for me. Honestly, I don’t get ANY blisters any more!! Even after putting them through their paces on the Overland track last year. I’m not saying they’re a cure-all that will necessarily work for everyone, but just to offer hope to the weird-footed creatures like me: it’s worth trying lots of different brands of shoe until you find THE ONE. Definitely and outlay but so worth it, and I barely know my hiking feet any more!!